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Yorkie who is 13 years old shows listlessness

20 11:37:32

QUESTION: My question relates to my yorkie who over the last 6 months has had bouts with shaking. I brought this to the attention of the vet and he thought it may be a tumor. I researched an area and found a site where it looked like he was suffering from Shaker syndrome. I put him on the med prednisolone. It looked to be working great until recently where he has been urinating often, larger appetite, frequent urination, dragging his back legs, seemingly listless walking around, and a unwillingness to jump around. He is still playful and acts normally for the most part, but my question is if this may be a brain tumor or a reaction to the medication that he is on?
I looked up the side effects of using this med and lists that cushing disease is a possiblilty. Could the original shaking have been from a tumor and now the effects are now being realized even more so? I have to say that the medication did work great with the shaking and not sure that now he is getting this disease because of it.
Also, the vet brought up the brain tumor thing and like to know what symptoms would cause such a diagnosis when this cushing disease seems to be the cause? What kind of cost is it to get a brain scan on my little dog to make sure there is not a mis-diagnosis.
Thanks so much


I usually don't answer this type of question because it is a medical question and I am not qualified to answer medical questions.  However, I think there is more going on here than the medical side of this.  I think that there are some emotional and ethical issues that need to be addressed.  I had a few questions that I wanted to address with you that might help you. They might be very difficult for you to hear so I will try to be as gentle as I possibly can without sugar coating the truth.

First of all, 13 years of age is old for any dog.  There are some that live to be as old as 21 years but that is the exception and not the rule.  The oldest mine have ever lived was 14 years of age and the last year of her life was not of a good quality.  My first question would be, do you trust your vet?  I ask this because I don't understand why you would put your dog on prednisolone without the permission of your vet.  I am also concerned that you were able to find somewhere to purchase prednisolone which is a prescription drug that usually must be prescribed by a vet in order to be able to purchase it.

Prednisolone is a corticosteroid.  The key here is the latter half of the word which is steroid.  Steroids are dangerous drugs if not taken correctly or in the proper dosage.  The problems that can occur are numerous and permanent damage can be done to almost all of the organs in the body. From the behavior your dog is showing I would say that it is possible that you have already done damage.  The problem now is that you cannot just stop giving the prednisolone to him.  Abruptly stopping the prednisolone can have even more serious consequences, including death.  You need to come clean with your vet and tell him what you have been giving your dog.  Together you can work out a plan to get him off the prednisolone as safely as possible.

As far as getting a brain scan, I am quite sure that they are very expensive.  If he does have a tumor getting the brain scan would certainly tell you but to what end?  So you find out he has one, will that change anything?  He is 13 years old and I am certain that they would not operate.  Any treatment they would be able to give him would only extend his life for a short time and you have to consider what that time would be like for him.  I know that this is not what you wanted to hear and I am so sorry that I am the one who has to tell you, but I believe in telling people the truth even if it is difficult for them to hear.

You also have to accept the possibility that your Yorkie is just old and it may be his time to go.  I know this is a difficult thing to do but you must remember that sometimes the kindest thing you can do is accept that nature must run its course and that your little boy has had a good life, but it is now time to let him go.  You must ask yourself the hard questions, am I doing this for him or for me?  Am I prolonging his life and making him suffer so that I can keep hanging on?  Is his quality of life what I want it to be?  Could the reason you sought your own diagnosis be because you didn't want to face the truth?

I have listed below some of the problems and complications that are associated with the use of corticosteroids like prednisolone.  You probably have already read some of these but I am putting them here so that others will have the knowledge that they provide.

Please accept my sincere sympathies for what you are going through and for the difficult decisions that you will have to make in the coming future.

Prednisolone and Corticosteroid Dangers

Chronic or inappropriate use of corticosteroids, including prednisone, can cause life threatening hormonal and metabolic changes

Corticosteroids suppress immune response. Animals receiving systemic corticosteroids may be more susceptible to bacterial or viral infections.

Corticosteroids should be avoided or used very carefully in young animals both because of immune suppression and the risk of GI ulcers

Digitalis and potassium levels should be closely monitored in animals taking prednisone.

Corticosteroids may increase insulin requirements. Estrogen may potentiate the effects of corticosteroids.

Drugs that may cause drug interactions with prednisone include salicylate, phenytoin, phenobarbital, rifampin, cyclosporin, erythromycin, mitotane and anticholinesterase drugs such as neostigmine and pyridostigmine.

Problems associated with long-term administration of prednisone relate to suppression of normal adrenal function, iatrogenic Cushing's disease and metabolic crisis due to abrupt withdrawal.

Precautions and Side Effects

While generally safe and effective when prescribed by a veterinarian, prednisone can cause side effects in some animals.

Prednisone should not be used in animals with known hypersensitivity or allergy to the drug.

Prednisone should be avoided in fungal infections.

Prednisone should not be used in pregnant animals, since it can induce labor.

Extreme care must be taken when stopping prednisone therapy. If an animal has been on prednisone for an extended period of time, slow weaning off the drug is critical to avoid serious complications.

Prednisone may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with prednisone. Such drugs include non-steroidal anti-inflammatories.

Adverse effects include increased thirst and appetite, panting, vomiting, restlessness and diarrhea.

Some animals may develop stomach ulcers from prednisone use.

Long-term use of prednisone may result in loss of hair coat, weakening of the muscles, liver impairment and behavioral changes.

Medication should never be administered without first consulting your veterinarian.

Doses of prednisone vary widely depending on the reason for prescribing.

Anti-inflammatory doses range from 0.1 to 0.3 mg per pound (0.2 to 0.6 mg/kg) up to twice daily.

Immunosuppressive doses range from 1 to 3 mg per pound (2 to 6 mg/kg) up to three times daily.

Doses for various diseases range between 0.1 to 3 mg per pound (0.2 to 6 mg/kg).

The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse.

---------- FOLLOW-UP ----------

QUESTION: Thanks for your response and think you misconstrued my original question. The vet did put him on the meds and I didn't "get" them from somewhere else. I haven't done any damage to my dog through any variant of dosing that wasn't already prescribed. Whatever, I am not concerned with how you responded to that portion. My only request is that if he being on the steroid could be pushing him to Cushing's disease rather than a tumor? Or is it possible he could have a brain tumor. All the sites I have read is that brain tumors are rare in Yorkies but obviously there are exceptions.
I understand all the points you made about older dogs. I have had plenty of animals in my life to know there is always an end. I am not making emotional decisions, only those that are practical in the symptoms he is showing. If everyone gave up on finding clues as to condiions there animals were showing then there would be no advancements to helping dogs or anyone for that matter from getting better.
Thanks for your quick repsonse to my question.  


I am totally sorry I didn't understand the question and did not mean to imply that you didn't know what you were doing.  Yes, the medication could be causing him to show symptoms of other illnesses.  The potential side effects that I mentioned before are in my opinion, scary at best.  While I agree that brain tumors are not as common in small dogs as large ones you are correct when you say that doesn't mean that is not the problem.  

I have had large breed dogs that had brain tumors later in life and one Yorkie that we suspected had a brain tumor.  The problem with diagnosing them is that taking an x-ray or brain scan does not necessarily mean you will see the tumor.  Based on where the tumor is in the brain, the problems and signs can vary greatly.  The large do I had that had a brain tumor would suddenly and for no apparent reason start to pant and druel and shake.  She would inevitably end up going in a room and pawing the door closed.  Then she would freak out and scratch big holes either in the door or drywall next to the door.  The episodes became closer together, lasted longer and became worse as she got older.  The Yorkie had different symptoms.  She would seem perfectly healthy one day, running and playing and then seem totally out of it the next.  She became more and more sluggish and then one day she developed breathing problems.  

It is difficult to say if your Yorkie is having the problems that he is having because of the medication or a brain tumor.  I can only tell you that if it were my dog I would take him off the prednisolone and see if that makes a difference.

Again, I apologize for misunderstanding.